Friday, August 13, 2010

Stories from the Clippings

When Will Peace Reign?

For a couple of weeks we have been examining the State Board of Higher Education vs. the members of the Oregon State Medical Society. You will remember that the construction of the University of Oregon Medical School teaching hospital was in progress. The building was climbing heavenward atop Marquam Hill on the University of Oregon Medical School campus and would hopefully open in January of 1956.

In September 1954, the board announced an adversarial policy or two, regarding fees and full-time faculty that led to heated debates and even a fist fight. I have read in the clippings that other county medical societies, including the medical societies of Marion-Polk County, Multnomah County and Lane County, had no bone to pick with the policies. But of all 26 societies in Oregon, not all were in agreement. Some groups refrained from voicing a position, saying that they just didn't have enough information. A rather long and detailed editorial of sorts by Oregonian staff writer, Herman Edwards, summarizes the issues and offers an opinion or two, but as of yet in my clipping research, the daily news had not reported on a resolution.

Was it just a small group of physicians who were attempting to force change to the already established but "flexible" policies, or was there discontent among others, Edwards asked? The OSMS, we know, was spearheading the movement in opposition. Regardless, the breach between those physicians who wanted to maintain private practice and still remain on faculty, treat the indigent to avoid the pitfall of becoming simply another general hospital, was widening with the two factions firmly planted on either side of the breach. It appeared, opined our author, that the OSMS was not the spokesperson for the majority of Oregon physicians.

The board made three points that were well taken by most: #1, admissions should not be limited to indigents if the paying patient's condition had added training value; #2, fees will be collected from those who can pay; and #3, there will be no council of five to advise the board. On this, they would not budge! (A new point we have not yet encountered).

All the while, vicious accusations and recriminations were flying, reputations were at stake, the school doctors were under fire, but at the same time they were charging that the private physicians were consumed with greed, jealousy and selfishness. Edwards offered that it was a well known fact that the feud between the board and the Society over the policies was not the main issue; in fact, it was a fairly new concern. Rather, it was a war of long standing over sovereignty and criticisms by the Society over school practices. It was a war in which personal animosities wreaked havoc. What damage might this attack on the school cause? And, as well, how might public health suffer if the school reigned over private medical practice and surgery? Public confidence in the school and practitioners could be shaken by such revelations of personal acrimony and non-professionalism.

Speaking for the Oregonian, Edwards declares that with matters of such import, it is the right of the people to know what is going on. The articles printed in the Oregonian, some of which had been proposed by some of the principal parties in the controversy, were meant to keep the public up to date. And physicians not enmeshed suggested that a "good airing" was what was needed. On which side did all of the 1600 members of the Society stand? And an additional proposition by many was that the Society should liaison between the school and the other societies in the state. And, what's more, the Society felt that they were the torch bearers, imbued with the power to awaken apathetic physicians. An open fight is the only way to bring resolution, they avowed.

Arguments swelled. The voice of those who opposed cried, "… a few firecrackers don't make a Fourth of July". This is nothing more than a small vocal minority, a few zealots, and a malicious hard-core of malcontents. But the Society, the group of individuals accused of having no values or principles took it to the legislature, sending two bills to authorize an advisory council (the dental school had one, they argued) and another to prohibit the initiation of fee-collecting (but Doernbecher charged fees and served the indigent and paying patients, which provided for 15% of operations. There went their argument). They wanted a voice in school affairs. The board, they charged, is an organization of laymen with the exception of their current president, Kleinsorge. But no, said the board, what they really want is a supervisory role. But the Society president, O. A. Pitman denied that they had intent to control. Members of the board threatened to leave if authority became divided. The fear of divided authority was grounded in the wording of the bill stated thus: "to have access to all official records necessary for them to discharge their advisory duties".

The "downtown" doctors enjoyed the privilege and the prestige of teaching at the school and the opportunity to share their expertise with students but also took advantage of the latest in technologies and technique from leading practitioners, while still earning stupendous private salaries. Accusations of conflict of interest and personal gain at the school were denied by Dean W. E. Baird. Baird was targeted by the Society. For one, he was charged with trying to dominate private practice through the school's policies. But Baird laid the blame for the lack of cooperation between the school and the Society at the Society's door. He claimed that the members of the Society had been offered opportunities to visit the school and to discuss the policies but these invitations were essentially ignored. The Society countered that perhaps if Dean Baird were removed, the end of the controversy might be possible and that the sinking morale among the staff of the school was the reason that they were scraping the bottom of the barrel for qualified instructors.

The staff was loyal to Dean Baird. He knew that many physicians could earn more in private practice but chose to be educators. The proof that they were not scraping the bottom of the barrel was in the increase in grants to outstanding doctors for research. He did not deny that there had been violators, but that a perversion of funds was impossible since the monies were deposited and managed by the State.

The argument continued, but for how long? Edwards asked at the end of his near prospectus, "What will happen if the feud is not settled but breaks out in violent eruptions?" Would it end before a grand jury? Would Society members who serve at the medical school be forced to resign from the Society? Would there be a strike at the school? The Society denied that there was strike organization a foot, though one high standing Society member had been heard in a public meeting saying that perhaps it might be best if doctors just stay off the hill.

Complex and convoluted are terms that sufficiently describe our story. Time and patience it will take to uncover the answers to these questions.

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